Review ‘Myocardial hibernation’—questions and controversies 1

The term ‘hibernation ’ has been borrowed from zool-ogy and implies an adaptive reduction of energy expendi-ture through reduced activity in a situation of reduced energy supply. In the context of coronary artery disease, myocardial hibernation was originally seen as a chronic, adapti˝e reduction of myocardial contractile function in response to a reduction of myocardial blood flow. It was also viewed as a condition where there would be a com-plete recovery of contractile function upon restoration of flow. Thus, in the concept of myocardial hibernation, the observed chronic reduction of myocardial contractile func-tion was not regarded as the result of a persistent energetic deficit, but instead as a regulatory event which acted to avoid an ongoing energy deficit and thereby maintain myocardial integrity and viability